The UCSF Abundant Life Health Ministries Initiative (ALHMI) focuses - not on delivering health promotion via the church - but on enhancing the capacity of churches to themselves promote health. AHLMI is part of an academic-faith partnership established in 2005 that subsequently took on the mission of fostering health ministries as a means to reduce health disparities and to do so through dissemination or development of evidence-based interventions designed specifically for the Black church. The AHLMI model has four capacity-building components: outreach, mini-grants to churches who commit to form a health ministry and to begin by adopting an evidence-based intervention, training in health ministry development and maintenance and adoption of specific interventions, and ongoing technical assistance. The proposed study is an exploration and test of the ALHMI model. The significance of this research is based on the assumption that the African American church can and should be a great force for addressing health disparities. Faith-based intervention research has progressed in this direction but is limited by a lack of understanding of how and why churches can effectively prioritize health, how such efforts can be sustained over the long term, and the mechanisms essential to these aspects of church capacity to prioritize and promote health. The innovations of this study include the focus on capacity in the form of health ministries, a highly contextualized approach based on an understanding of churches as complex and dynamic organizations, emphasis on real-world "practice-based" use and generation of evidence, and conceptualization of sustainability as based on enduring and highly participatory academic-faith partnerships. We propose a developmental inductive mixed methods study to elucidate the mechanisms of capacity for sustained health interventions by health ministries. We will conduct comparative case studies which will be examined in relation to process and impact data collected in the course of implementation of the Body &Soul fruits and vegetables intervention. Our specific aims are: 1) To expand the capacity of SF Bay Area African American churches to deliver and sustain evidence- based health promotion interventions by fostering the development of 10 new health ministries and strengthening 10 existing health ministries per year for two years; 2) To measure the impact of this program on key behaviors among 1500 congregants in a delayed intervention controlled trial; 3) To assess and demonstrate expanded church capacity in 10 churches using comparative case studies that include records of health program activities, key informant interviews, and observations. PUBLIC HEALTH RELEVANCE: Program Narrative This study will assess and explore the meaning and implications of a health ministries model developed by an academic-faith partnership that is dedicated to fostering the capacity of African American churches to address health disparities. In this context, we also propose to evaluate a "real-world" application of an evidence-based intervention, Body &Soul, implemented with minimal resources.